Fungi (EXAM 3) Flashcards
What type of cells are invaded by fungi?
-dead cells of the stratum corneum layer of
the skin
-hair and nails
Most common form of tinea?
Tinea pedis (feet)
How is tinea spread among people?
Person-to-person or fomites (Towels, showers, clothes)
Risk factors for fungi
Skin trauma
Immune suppression (diabetes)
Summer and tropical climate
Sweating and occlusive clothing, poor circulation
poor nutrition and hygiene
Tinea capitis
Tinea corporis
Tinea capitis - head
Tinea corporis - body (Ringworm - oval shape)
Tinea cruris
Tinea pedis
Tinea unguium
Tinea cruris - groin
Tinea pedis - foot
Tinea unguium - nail
Signs and Symptoms of Fungi
Malodor
Thickened skin, scaling
Maceration, skin erosion
Vesicular rash (fluid-filled blisters)
Inflammation
Cracks, fissures, crusting
Itching, stinging, pain
Tinea Capitis
single hair follicles -> spreads
Tinea favus: patchy hair loss
-May lead to secondary bacterial infections, atrophy, scarring, alopecia
-common in children
Two types of Tinea Capitis
Non-inflammatory: Yellow scaling
Inflammatory: Pustules to kerions
Tinea Corporis
-ringworm shape, inflammed border
-can affect trunk and limb, also any area
Risk factors of Tinea Corporis
-Children in daycare centers
-Contact sport (wrestling)
-Hot, humid climate
-Obesity (skin falts)
Tinea Cruris
(tighs and groin)
-Medial and upper thighs and groin are
-Acute lesions are bright red (inflamed)
-bilateral
-avoid wood or synthetic fibers/underwear
Tinea Pedis
-in lateral toe webs and sole of the foot
-> White, scaly patches; Red, inflamed area with demarcated borders
-aggravated by damp socks and shoes; bathing facilities
Tinea Unguium
Fungal infection of nails and nail beds
-Toenails become yellow, thick, and brittle and lose their shiny luster
-nail may separate from nail bed
When to refer
-cant trace back the cause, an odd spot with less exposure
-severe (inflamed, secondary bacterial infection, fever)
-immunocompromised (grey area) (diabetes, systemic infection, immunodeficiency) (grey area - check-ups)
-treatment hasn’t worked or gotten worse
-patients under 2 y
Treatment duration
-Tinea corporis (core): 2-4 weeks
-Tinea cruris: 1-2 weeks
-Tinea pedis: 2-4 weeks
-Tinea capitis (head): REFER for inspection
-Tinea unguium: REFER - takes a lot of time to treat, no OTC products
How to treat Tinea pedis (athlete’s foot)
small vesicles, scaling between toes, NO inflammation
Topical antifungal agent
How to treat Tinea pedis (athlete’s foot)
Inflammatory lesions
Initial (drying - Astringent): Aluminum acetate solution, BID-TID up to 1 week
Secondary: Topical antifungal agent
How to treat Tinea pedis (athlete’s foot)
Wet, Soggy, No fissure
Initial: Aluminum chloride 20-30%, BID up to 1 week
Secondary: Topical antifungal agent
How to treat Tinea pedis (athlete’s foot)
Wet, Soggy, With fissure
Initial: Aluminum chloride 10%, BID for 1 week
Secondary: Aluminum chloride 20-30%, BID for up to one week
Tertiary: Topical antifungal agent
OTC product athletes’ foot
-Clotrimazole Nitrate 1% - LOTRIMIN
-Miconazole Nitrate 2% - Cruex Spray Powder, Desenex Liquid Spray, Micatin Cream, Lotrimin AF Powder
– Tinea pedis: twice daily for 4 weeks
– Tinea corporis: twice daily for 4 weeks
– Tinea cruris: twice daily for 2 weeks
OTC products with shorter duration! (more expensive)
-Terbinafine Hydrochloride 1% - LAMISIL
-Butenafine Hydrochloride 1% - LOTRIMIN ULTRA
-Tolnaftate 1% ??
DO NOT USE for patients under 12 y
Which dosage form is preferred for dry/scaly rash?
cream or solution (not for broken skin)
Which dosage form is preferred for a macerated, erosive rash?
Gels and sprays
